Introduction

Most episodes of diarrhea are self-limiting or will stop when the underlying cause (e.g. medications, lactose in patients with lactase deficiency) is removed. Dehydration and electrolyte abnormalities should be corrected and malnutrition minimized by continuing enteral nutrition or using parenteral nutrition when this proves impossible. Antidiarrheals, other than oral rehydration solutions, should not be given alone to patients with pseudomembranous colitis or acute diarrhea associated with enterotoxigenic Escherichia coli, Salmonella, or Shigella infections. When given together with appropriate antibiotics they usually shorten the period of symptomatic diarrhea, but antidiarrheals should still not be given to patients with high fever or bloody diarrhea. Toxic megacolon can be induced in patients with ulcerative colitis.

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